ADAMA SCIENCE AND TECHNOLOGY

UNIVERSITY
 1. HOSPITAL

Definition
A hospital is a health care institution providing patient treatment
by specialized staff and equipment.
Some patients go to a hospital just for diagnosis, treatment, or
therapy and then leave ('outpatients') without staying overnight;
while others are 'admitted' and stay overnight or for several days
or weeks or months ('inpatients'). Hospitals usually are
distinguished from other types of medical facilities by their ability
to admit and care for inpatients whilst the others often are
described as clinics
2. TYPES OF HOSPITAL
A. GENERAL
B. DISTRICT
C. SPECIALIZED
D. TEACHING
E. CLINICS
A. GENERAL
The best-known type of hospital is the general hospital, which is set up to
deal with many kinds of disease and injury, and normally has an emergency
department to deal with immediate and urgent threats to health. Larger
cities may have several hospitals of varying sizes and facilities. Some
hospitals have their own ambulance service.
B. DISTRICT
A district hospital typically is the major health care facility in its region, with
large numbers of beds for intensive care and long-term care;
C. SPECIALIZED
Types of specialized hospitals include trauma centers, rehabilitation hospitals,
children's hospitals, seniors' (geriatric) hospitals, and hospitals for dealing
with specific medical needs such as psychiatric problems certain disease
categories such as cardiac, oncology, or orthopedic problems
The number of specialist hospitals is growing fast because of the increasing
focus on individual types of treatment or medical fields dealing with, for
example, cancers, skin problems, lung conditions, psychiatric disorders,
D. TEACHING
A teaching hospital combines assistance to patients with teaching to medical
students and nurses and often is linked to a medical school, nursing school or
university.
University hospitals with maximum provision are to be considered equal to the
medical academies and some large general hospitals. They have at their disposal
particularly extensive diagnostic and therapeutic facilities and systematically carry
out research and teaching. Lecture theatres and demonstration rooms should be
included in such a way that operations are not interrupted by the observers. Larger
wards should be planned so as to accommodate both visitors and observers..
E. CLINICS
The medical facility smaller than a hospital is generally called a clinic, and often
is run by a government agency for health services or a private partnership of
physicians (in nations where private practice is allowed). Clinics generally
provide only outpatient services.
 3. DEPARTMENTS OF HOSPITAL
Hospitals vary widely in the services they offer and therefore, in the
departments (or "wards") they have. Each is usually headed by a Chief
Physician. These may then be backed up by more specialist units such
as:
 Emergency department
 Cardiology
 Intensive care unit
 Pediatric intensive care unit
 Neonatal intensive care unit
 Cardiovascular intensive care unit
 Neurology
 Oncology
 Obstetrics and gynecology and
others
 4. REQUIREMENTS
A hospital and other health facilities shall be planned and designed to observe
appropriate architectural practices, to meet prescribed functional programs, and
to conform to applicable codes as part of normal professional practice
1. Environment: A hospital and other health facilities shall be so located that it
is readily accessible to the community and reasonably free from undue noise,
smoke, dust, foul odor, flood, and shall not be located adjacent to railroads,
freight yards, children's playgrounds, airports, industrial plants, disposal plants.
2. Occupancy: A building designed for other purpose shall not be converted
into a hospital. The location of a hospital shall comply with all local zoning
ordinances
3. Safety: A hospital and other health facilities shall provide and maintain a safe
environment for patients, personnel and public. The building shall be of such
construction so that no hazards to the life and safety of patients, personnel and
public exist.
It shall be capable of withstanding weight and elements to which they may be
subjected.
3.1 Exits shall be restricted to the following types: door leading directly outside
the building, interior stair, ramp, and exterior stair.
3.2 A minimum of two (2) exits, remote from each other, shall be provided for
each floor of the building.
3.3 Exits shall terminate directly at an open space to the outside of the building

4. Security: A hospital and other health facilities shall ensure the security of
person and property within the facility.
5. Patient Movement: Spaces shall be wide enough for free movement of
patients, whether they are on beds, stretchers, or wheelchairs. Circulation
routes for transferring patients from one area to another shall be available and
free at all times
5.1 Corridors for access by patient and equipment shall have a minimum
width of 2.44 meters.
5.2 Corridors in areas not commonly used for bed, stretcher and equipment
transport may be reduced in width to 1.83 meters.
5.3 A ramp or elevator shall be provided for ancillary, clinical and nursing
areas located on the upper floor.
5.4 A ramp shall be provided as access to the entrance of the hospital not on
the same level of the site.
6. Lighting: All areas in a hospital and other health facilities shall be
provided with sufficient illumination to promote comfort, healing and
recovery of patients and to enable personnel in the performance of work.
7. Ventilation: Adequate ventilation shall be provided to ensure comfort
of patients, personnel and public.
8. Auditory and Visual Privacy: A hospital and other health facilities
shall observe acceptable sound level and adequate visual seclusion to
achieve the acoustical and privacy requirements in designated areas
allowing the unhampered conduct of activities.
9. Water Supply: A hospital and other health facilities shall use an approved
public water supply system whenever available. The water supply shall be
potable, safe for drinking and adequate, and shall be brought into the building
free of cross connections.
10. Waste Disposal: Liquid waste shall be discharged into an approved
public sewerage system whenever available, and solid waste shall be
collected, treated and disposed of in accordance with applicable codes, laws
or ordinances.
11. Sanitation: Utilities for the maintenance of sanitary system, including
approved water supply and sewerage system, shall be provided through the
buildings and premises to ensure a clean and healthy environment.
12. Housekeeping: A hospital and other health facilities shall provide and
maintain a healthy and aesthetic environment for patients, personnel and
public.
14. Material Specification: Floors, walls and ceilings shall be of sturdy
materials that shall allow durability, ease of cleaning and fire resistance.
15. Segregation: Wards shall observe segregation of sexes. Separate toilet shall
be maintained for patients and personnel, male and female, with a ratio of one (1)
toilet for every eight (8) patients or personnel.
16. Fire Protection: There shall be measures for detecting fire such as fire
alarms in walls, peepholes in doors or smoke detectors in ceilings. There shall be
devices for quenching fire such as fire extinguishers or fire hoses that are easily
visible and accessible in strategic areas.
17. Signage. There shall be an effective graphic system composed of a number
of individual visual aids and devices arranged to provide information,
orientation, direction, identification, prohibition, warning and official notice
considered essential to the optimum operation of a hospital and other health
facilities.
18. Parking. A hospital and other health facilities shall provide a minimum of
one (1) parking space for every twenty-five (25) beds.
Zoning: The different areas of a hospital shall be grouped according to zones
as follows:
19.1 Outer Zone – areas that are immediately accessible to the public:
emergency service, outpatient service, and administrative service. They shall
be located near the entrance of the hospital.
19.2 Second Zone – areas that receive workload from the outer zone:
laboratory, pharmacy, and radiology. They shall be located near the outer zone.
19.3 Inner Zone – areas that provide nursing care and management of
patients: nursing service. They shall be located in private areas but accessible
to guests.
19.4 Deep Zone – areas that require asepsis to perform the prescribed services:
surgical service, delivery service, nursery, and intensive care. They shall be
segregated from the public areas but accessible to the outer, second and inner
zones.
19.5 Service Zone – areas that provide support to hospital activities: dietary
service, housekeeping service, maintenance and motor pool service, and
mortuary. They shall be located in areas away from normal traffic.
20. Function: The different areas of a hospital shall be functionally related with
each other.
20.1 The emergency service shall be located in the ground floor to ensure
immediate access. A separate entrance to the emergency room shall be
provided.
20.2 The administrative service, particularly admitting office and business
office, shall be located near the main entrance of the hospital. Offices for
hospital management can be located in private areas.
20.3 The surgical service shall be located and arranged to prevent non-related
traffic. The operating room shall be as remote as practicable from the entrance
to provide asepsis. The dressing room shall be located to avoid exposure to
dirty areas after changing to surgical garments. The nurse station shall be
located to permit visual observation of patient movement
20.4 The delivery service shall be located and arranged to prevent non-related
traffic. The delivery room shall be as remote as practicable from the entrance
to provide asepsis. The dressing room shall be located to avoid exposure to
dirty areas after changing to surgical garments. The nurse station shall be
located to permit visual observation of patient movement. The nursery shall be
separate but immediately accessible from the delivery room.
20.5 The nursing service shall be segregated from public areas. The nurse
station shall be located to permit visual observation of patients. Nurse stations
shall be provided in all inpatient units of the hospital with a ratio of at least one
(1) nurse station for every thirty-five (35) beds. Rooms and wards shall be of
sufficient size to allow for work flow and patient movement. Toilets shall be
immediately accessible from rooms and wards.
20.6 The dietary service shall be away from morgue with at least 25-meter
distance.
21. Space: Adequate area shall be provided for the people, activity, furniture,
equipment and utility.
 5. HOSPITAL DESIGN CONSIDERATION
i. TECHNOLOGICAL ADVANCES
Most diagnostic practices and procedural functions in clinics and surgeries
are dependent on modern instruments, tools, and laboratory equipment.
Digitized X-rays and other images are being transmitted electronically to
all parts of the hospital and to doctors’ offices. Clinical laboratory test
results, prescriptions, and most forms of medical data are now instantly
available to medical practitioners.

When a disaster, such as Hurricane, disables or impairs the functioning of

electronic equipment and data transmission systems, or even the hospital
voice communications systems, the ability of the medical staff to care for
their patients is significantly reduced.
Emergency power systems, therefore, become the critical component for
maintaining hospital’s functions.
 ii. HAZARD MITIGATION

Mitigation is defined as any sustained action taken to reduce or

eliminate long term risk to life and property from hazard events.
The goal is to save lives and reduce property damage in ways
that are cost-effective and environmentally sound.

Hazard mitigation measures should be integrated into the process

of planning and design because they reduce casualties and
damage resulting from building failures during hazard events.
The starting point for such an assessment should be a general review
of the existing hospital network in the area—its operational
characteristics, geographical distribution, the degree to which it is able
to meet health care needs and expectations, the epidemiological and
demographic pro-file of the population served, and the natural hazards
that threaten the provision of medical services.

The effective functional capacity of all ex-isting hospitals should be

taken into account, considering as fully as possible all factual
information on the natural hazards they face and their current level of
vulnerability.
 iii. ASSESSING RISK
Any funds invested in making a hospital facility safer for patients and
staff, more resistant to damage, or capable of continued operations in a
post-disaster situation must consider the following questions:
What types and magnitudes of hazard events are anticipated at the
site?
What are the vulnerabilities of the site or existing building to natural
hazards?
What are the anticipated frequencies of hazard events?
What level of loss/damage/injury/death, if any, is acceptable?
What might be the financial impact of extended downtime on the
institution?
What is the impact to the community if the hospital cannot maintain
operations in the aftermath of a disaster?
 iv. EVACUATION CONSIDERATIONS

In anticipation of high winds or flooding, timely evacuation of some or all of the

hospital patients to facilities out of the disaster area may sometimes be a prudent
choice for patient welfare.
Many patients have limited mobility and some are on critical life sup-port,
oxygen or other medical gasses, ventilators, or Pumps. Moving these patients
to evacuate the hospital is difficult and requires highly trained staff. In each
geographical area, acute care facility managers must evaluate the likely time
that they would need to hold patients, how many additional patients might
arrive seeking care, and what services would be needed and for what
period of time
 v. POTENTIAL VULNERABILITIES
Three main aspects of hospital
vulnerability must be taken into account:
Structural
Nonstructural
Organizational

Structural Vulnerability
The level of vulnerability of these components depends on the following
factors:
The level to which the design of the structural system has addressed
the hazard forces
The quality of building materials, construction, and maintenance
The architectural and structural form or configuration of a building
Nonstructural vulnerability
The experience of hospital evacuations and other types of disruption during
recent hazard events has heightened the awareness that hospital functions
could be seriously impaired or interrupted, even when the facilities did not
sustain significant structural damage.
The effects of damage to nonstructural building components and equipment,
as well as the effects of breakdowns in public services (lifelines),
transportation, re-supply, or other organizational aspects of hospital
operations, can be as disruptive, and as dangerous for the safety of patients,
as any structural damage
x. Spatial and Other Organizational Vulnerabilities

most hospitals have disaster mitigation or emergency operation plans,

but not all of them provide organizational alternatives in the event of
disruption of the normal movement of staff, patients, equipment, and
supplies that characterizes everyday hospital operations. The critical
nature and interdependence of these processes represent a separate
category of vulnerabilities that need careful attention. Spatial
distribution of hospital functions and their inter-relationship
determines the extent hospital operations are affected when normal
movement and communication of people, materials, and waste are
disrupted.
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YOU!